A Computerized Lifestyle Application to Promote Multiple Health Behaviors at the Workplace: Testing Its Behavioral and Psychological Effects.
A Computerized Lifestyle Application to Promote Multiple Health Behaviors at the Workplace: Testing Its Behavioral and Psychological Effects.
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DOI：
10.2196/jmir.4486
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发表时间：
2015-10-01
影响因子：
7.4
通讯作者：
Schwarzer R
中科院分区：
文献类型：
--
作者：
Lippke S;Fleig L;Wiedemann AU;Schwarzer R
建议采取预防性的健康行为，如定期体育锻炼和健康营养，以保持就业能力和促进员工的健康。以理论为基础的工作场所健康促进需要包括心理结构，并考虑员工的激励准备(所谓的变化阶段)。根据阶段的不同，人们可以分为非意向者(没有动机改变，也不执行目标行为)、意向者(决定采用目标行为，但还没有开始)或行为者(已经执行目标行为)。针对这些阶段的量身定做可以在计算机上进行，应该会使工作场所的健康促进更加有效。研究人员测试了在工作场所实施的节俭的基于计算机的健康促进计划在改变生活方式、心理结果以及体重方面是否有效。我们假设阶段匹配干预将优于一刀切的主动控制条件(标准护理干预)。在一项随机对照试验中，共有1269名员工在他们的工作场所接受了常规体检，由一名训练有素的研究助理招募。剔除不符合条件的员工后，560人完成了时间1(T1)，384人也完成了时间2(T2)，保留率为68.6%。采用了两种完全自动化的计算机治疗：(1)主动控制条件，提供运动和健康营养益处的信息(n=52)，或(2)阶段匹配的多行为干预，为9个亚组提供不同的心理治疗，解决变化的阶段(非意向者、意向者和行为者；n=332)。4周后(T2)重复对行为、心理结构和体重的基线评估(T1)。阶段匹配干预在改变生活方式方面优于主动控制条件(χ2 1=3.5；P=0.0 4，N=384)和心理变量(身体活动意向，P=0.0 4；营养意向，P=.03；营养规划，P=.0 2；健康生活的一般社会支持，P=.01)。当预测健康的生活方式时，基线生活方式(OR，2.25，95%CI 1.73-2.92；P<；.01)和干预(OR 1.96，95%CI 1.00-3.82；P=0.05)被发现是显著的预测因素。体力活动计划对采取整体健康生活方式(包括运动和营养，R2 adj=0.08；P<；0.01)的干预效果起中介作用，表明如果阶段匹配的干预增加了计划，采用健康生活方式的可能性更大。将干预措施与员工的激励准备相匹配，可以使健康促进计划有效。员工的动机、计划、社会支持和生活方式可以通过注重体力活动和健康营养的阶段匹配干预来支持。职业环境提供了实施节俭的基于计算机的健康促进计划的潜力，并促进了多种行为的改变。
Preventive health behaviors, such as regular physical activity and healthy nutrition, are recommended to maintain employability and to facilitate the health of employees. Theory-based workplace health promotion needs to include psychological constructs and consider the motivational readiness (so-called stages of change) of employees. According to the stages, people can be grouped as nonintenders (not motivated to change and not performing the goal behavior), intenders (decided to adopt the goal behavior but not started yet), or actors (performing the goal behavior already). The tailoring to these stages can be done computer based and should make workplace health promotion more effective. It was tested whether a parsimonious computer-based health promotion program implemented at the workplace was effective in terms of lifestyle changes and psychological outcomes as well as body weight. We hypothesized that the stage-matched intervention would outperform the one-size-fits-all active control condition (standard care intervention). In a randomized controlled trial, a total of 1269 employees were recruited by a trained research assistant at their workplace during a routine medical examination. After excluding noneligible employees, 560 completed Time 1 (T1), and 384 also completed Time 2 (T2), achieving a retention rate of 68.6%. Two fully automated computer-based treatments were adopted: (1) an active control condition with information about benefits of exercise and healthy nutrition (n=52), or (2) a stage-matched multiple-behavior intervention that provided different psychological treatments to 9 subgroups, addressing stages of change (nonintenders, intenders, and actors per behavior; n=332). Baseline assessments (T1) on behavior, psychological constructs, and body weight were repeated after 4 weeks (T2). The stage-matched intervention outperformed the active control condition for lifestyle changes containing physical activity and nutrition (χ2 1=3.5; P=.04, for N=384) as well as psychological variables (physical activity intention, P=.04; nutrition intention, P=.03; nutrition planning, P=.02; and general social support to live healthily, P=.01). When predicting a healthy lifestyle at follow-up, baseline lifestyle (odds ratio, OR, 2.25, 95% CI 1.73-2.92; P<.01) and the intervention (OR 1.96, 95% CI 1.00-3.82; P=.05) were found to be significant predictors. Physical activity planning mediated the effect of the intervention on the adoption of an overall healthy lifestyle (consisting of activity and nutrition, R 2 adj=.08; P<.01), indicating that if the stage-matched intervention increased planning, the adoption of a healthy lifestyle was more likely. Matching an intervention to the motivational readiness of employees can make a health promotion program effective. Employees’ motivation, planning, social support, and lifestyle can be supported by a stage-matched intervention that focuses on both physical activity and healthy nutrition. Occupational settings provide a potential to implement parsimonious computer-based health promotion programs and to facilitate multiple behavior change.